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Remote ischemic preconditioning for cerebral and cardiac protection during carotid endarterectomy: results from a pilot randomized clinical trial.
Vasc Endovascular Surg 2010; 44(6):434-9VE

Abstract

Remote ischemic preconditioning (RIPC) is a physiological mechanism whereby brief ischemia-reperfusion episodes attenuate damage by subsequent prolonged ischemic insults. It reduces myocardial injury following cardiac and aortic aneurysm surgery. We aimed to determine whether RIPC affects neurological or cardiac injury following carotid endarterectomy (CEA). Patients were preconditioned using 10 minutes of lower limb ischemia-reperfusion. The primary neurological outcome was saccadic latency deterioration. The primary cardiac outcome measure was increased in serum troponin I >0.15 mg/dL. In all, 70 patients were randomized, of whom 55 completed the neurological surveillance protocol. Although there were fewer saccadic latency deteriorations in the RIPC arm, this did not reach statistical significance (32% versus 53%; P = .11). The primary cardiac outcome occurred in 1 patient in each arm (P = .97). There were no adverse events related to the preconditioning protocol. Remote ischemic preconditioning appears safe in patients with CEA. Large-scale trials are required to determine whether RIPC confers clinical benefits.

Authors+Show Affiliations

Cambridge Vascular Unit, Addenbrooke's Hospital, Cambridge, United Kingdom. srwalsh@doctors.org.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20484064

Citation

Walsh, Stewart R., et al. "Remote Ischemic Preconditioning for Cerebral and Cardiac Protection During Carotid Endarterectomy: Results From a Pilot Randomized Clinical Trial." Vascular and Endovascular Surgery, vol. 44, no. 6, 2010, pp. 434-9.
Walsh SR, Nouraei SA, Tang TY, et al. Remote ischemic preconditioning for cerebral and cardiac protection during carotid endarterectomy: results from a pilot randomized clinical trial. Vasc Endovascular Surg. 2010;44(6):434-9.
Walsh, S. R., Nouraei, S. A., Tang, T. Y., Sadat, U., Carpenter, R. H., & Gaunt, M. E. (2010). Remote ischemic preconditioning for cerebral and cardiac protection during carotid endarterectomy: results from a pilot randomized clinical trial. Vascular and Endovascular Surgery, 44(6), pp. 434-9. doi:10.1177/1538574410369709.
Walsh SR, et al. Remote Ischemic Preconditioning for Cerebral and Cardiac Protection During Carotid Endarterectomy: Results From a Pilot Randomized Clinical Trial. Vasc Endovascular Surg. 2010;44(6):434-9. PubMed PMID: 20484064.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Remote ischemic preconditioning for cerebral and cardiac protection during carotid endarterectomy: results from a pilot randomized clinical trial. AU - Walsh,Stewart R, AU - Nouraei,S A, AU - Tang,Tjun Y, AU - Sadat,Umar, AU - Carpenter,Roger H, AU - Gaunt,Michael E, Y1 - 2010/05/18/ PY - 2010/5/21/entrez PY - 2010/5/21/pubmed PY - 2011/1/14/medline SP - 434 EP - 9 JF - Vascular and endovascular surgery JO - Vasc Endovascular Surg VL - 44 IS - 6 N2 - Remote ischemic preconditioning (RIPC) is a physiological mechanism whereby brief ischemia-reperfusion episodes attenuate damage by subsequent prolonged ischemic insults. It reduces myocardial injury following cardiac and aortic aneurysm surgery. We aimed to determine whether RIPC affects neurological or cardiac injury following carotid endarterectomy (CEA). Patients were preconditioned using 10 minutes of lower limb ischemia-reperfusion. The primary neurological outcome was saccadic latency deterioration. The primary cardiac outcome measure was increased in serum troponin I >0.15 mg/dL. In all, 70 patients were randomized, of whom 55 completed the neurological surveillance protocol. Although there were fewer saccadic latency deteriorations in the RIPC arm, this did not reach statistical significance (32% versus 53%; P = .11). The primary cardiac outcome occurred in 1 patient in each arm (P = .97). There were no adverse events related to the preconditioning protocol. Remote ischemic preconditioning appears safe in patients with CEA. Large-scale trials are required to determine whether RIPC confers clinical benefits. SN - 1938-9116 UR - https://www.unboundmedicine.com/medline/citation/20484064/Remote_ischemic_preconditioning_for_cerebral_and_cardiac_protection_during_carotid_endarterectomy:_results_from_a_pilot_randomized_clinical_trial_ L2 - http://journals.sagepub.com/doi/full/10.1177/1538574410369709?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -